Coronavirus: How Taiwan avoided crisis in spite of China links

As the world struggles to contain outbreak, Taiwan’s success story shines a light on how countries might survive the global epidemic, writes William Yang in Taipei

Taiwanese people wearing masks as a precautionary measure walk in a Taipei street (EPA)

At about 4pm every day, long lines form outside most drug stores across Taiwan’s capital as everyone waits to collect their daily ration of face marks. But where in other parts of the world there have been scenes of panic buying and stockpiling, in Taipei there is a sense of calm among the crowds.

As Europe struggles to deal with the rapid spread of coronavirus, Taiwan can offer some valuable lessons, having been well prepared for the current epidemic.

About 850,000 Taiwanese citizens live and work in China and yet despite the potential for mass contagion from the mainland, the state has only seen one death and 47 contaminations.

Even when taking population differences into account, it is a stark difference to Chinas 80,754 cases and 3,136 deaths. It has the lowest incidence rate per capita of the world – about one in every 500,000 people.

In February, soon after cases started to spike in China, Taiwan quickly introduced a travel ban for all visitors coming from mainland China, Hong Kong and Macau. The government also banned the export of surgical masks from Taiwan, to ensure stock remained high, and rationed their use – three per citizen per week. South Korea and France have both adopted similar measures over the past few days.

Taiwan has also learnt important lessons from the Sars epidemic.

“The most important thing is to prepare for the crisis, and Taiwan did that after the Sars epidemic in 2002 and 2003, as they established the National Health Command Centre [NHCC],” Dr Jason Wang, director of the Centre for Policy, Outcomes and Prevention at Stanford University, told The Independent.

By creating a centralised system – as the UK has with the NHS – Taiwan has been able implement state-wide measures quickly.

“The NHCC allows people to work together, using data from different regions across the country,” Dr Wang said. “It is an integrated way to deal with a crisis.”

To help frontline medical staff identify patients who might have contracted coronavirus, the Taiwanese government uses data from the state’s national healthcare system along with immigration and customs data. Doctors and nurses are then able to raise their alert level when data shows a patient has travelled to countries that are seriously affected by coronavirus. Thermal scanners have also been placed at airports.

“The government developed a system where passengers can scan a QR code before boarding a flight to Taiwan and start filling out their travel information, their symptoms and their contact information,” Dr Wang explained.

“Once they land in Taiwan, they will receive a text message on their phone, which will indicate their health status. This mechanism allows customs officers to skip passengers with low risk of carrying coronavirus and focus on high-risk passengers.”

Preparation made by frontline medical staff has also proven critical.

A thermal scanner monitors passengers’ temperatures at a station in Taipei (EPA)

“When the Taiwanese government informed us about the emergence of mysterious Sars-like pneumonia cases in Wuhan last December, our hospital started reviewing the amount of medical supplies that we have in stock,” said Dr Daniel Lu, a paediatrician and executive director of the Taiwan Association for Global Health Diplomacy.

Dr Lu credits Taiwan’s streamlined chain of command between the central government and local hospitals for its preparedness for the outbreak, as frontline medical staff are ready to act whenever the government issues a command.

“We know the danger of coronavirus, so when the government issues a new regulation, Taiwan’s frontline medical personnel will start to assign responsibilities in a systematic way. I think this is one of the biggest differences between Taiwan and other countries.”

Cultural factors also play a part, with Dr Chunhuei Chi, professor at Oregon State University’s College of Public Health and Human Sciences, arguing that, in general, people in Taiwan have had a receptive attitude to government measures.

“Most Taiwanese experienced the hardship and interrupted life during the Sars epidemic,” Dr Chi explained. “That memory is still fresh, which [helps to foster] a sense of community [among the general public]. People realise that they are in this together and that makes them willing to comply with [the measures rolled out] by the government.”

And despite being blocked from joining the World Health Organisation by China, Taiwan continues to engage with other countries during the coronavirus outbreak. “The Taiwanese government organised a teleconference with other countries to talk about their disease prevention strategies while helping countries with no advanced medical capabilities to process samples from patients,” Dr Wang explained. “The Taiwanese government is already engaging with other countries by offering to help them prevent the coronavirus outbreak.”

It is perhaps through this dialogue that other countries can learn how Taiwan managed to become a coronavirus success story.